This factsheet was prepared for Housing Options by Sian Lockwood of NAAPS UK. We are very grateful for her time and contribution.

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1 This factsheet was prepared for Housing Options by Sian Lockwood of NAAPS UK. We are very grateful for her time and contribution. Description and Characteristics Shared Lives Supported Lodgings Regulation Who are they for? Support Funding Security Maintenance and Repair Risks Pros and Cons Comments and Issues Description and Characteristics One way the inherent problems of shared group housing or living in large institutions can be overcome has been for people to have the opportunity to live with a family or in supported lodgings. Accommodation with a family, where sharing family life is part of the arrangement, is referred to as Shared Lives (formerly Adult Placement). Accommodation in the home of a landlord where family life is not shared is known as Supported Lodgings. Confusingly some Shared Lives families are also called Supported Lodgings providers this usually means that they offer a lower level of support which is often housing related. Shared Lives families can offer a full range of support including personal care. Supported Lodgings providers do not offer personal care. People using both type of scheme have to be over 18 years of age. There is no upper age limit. The two types of scheme are funded differently and subject to different levels of support and supervision. Shared Lives Shared Lives (SL) arrangements are distinguished by the following features: SL arrangements are part of organised SL Schemes that approve and train the SL Carers, receive referrals, match the needs of service users with SL Carers and monitor the arrangements People using SL services have the opportunity to be part of the SL Carer s family and social networks SL Carers can use their family home as a resource SL agreements provide committed and consistent relationships The relationship between the SL Carer and the person placed with them is of mutual benefit SL Carers can support up to three people at any one time (two in Wales) SL Carers do not employ staff to provide care to the people that they support

2 SL Carers can provide Long term accommodation and support Short breaks Day time support Rehabilitative or intermediate support Kinship support where the SL Carer acts as 'extended family' to someone living in their own home In a Shared Lives arrangement that offers accommodation, the individual usually shares the whole house and mealtimes whilst having the privacy of their own bedroom. Shared Lives Schemes are registered by the Commission for Social Care Inspection. The Schemes in turn monitor individual placements. Families offering Shared Lives accommodation and care no longer have to register as small homes. Matching is a key feature of Shared Lives arrangements. Matching of the individual and the Shared Lives family is usually done by a Shared Lives Worker in close consultation with the person and their family, their care manager and other key people who know the individual well. In Shared Lives the host family undergoes a thorough assessment and approval process to make sure that they have the skills and knowledge to carry out their work. The process involves a number of meetings, a comprehensive training programme and presentation to an Approval Panel. Shared Lives families receive on-going support from a Shared Lives Worker. They receive a weekly payment for their work. There are now more than 200 Shared Lives schemes around the country with an estimated 10,000 people making use of them. The majority of Shared Lives Schemes are directly managed by local authorities but there is mounting interest from the independent sector to win contracts with Local Authorities to run such services. Shared Lives Schemes originally offered long term accommodation and support but there has been growth in the last ten years of a range of other services including short breaks and day time support. Kinship support (where the Shared Lives family supports someone living in their own home) is the most recent area of growth and is offered in most areas of the UK. Supported Lodgings In Supported Lodgings individuals receive a low level of (usually housing related) support and do not share in the family life of the landlord. Supported Lodgings Schemes are not registered with the Commission for Social Care Inspection as they do not offer personal care. Landlords do not undergo the same level of assessment as Shared Lives Carers and usually receive less support from the Scheme. They are more independent and are not subject to the same matching process. All the costs associated with placements are met by the person living in the accommodation. Supported Lodgings can cater for more than three people.

3 Regulation Shared Lives is a highly regulated service but the regulatory approach has changed over the years. Shared Lives was unregulated until 1993 when the implementation of the Registered Homes (Amendment) Act 1991 brought Shared Lives arrangements within the scope of legislation governing small homes. This required all small homes with fewer than four residents to be registered including shared lives arrangements providing board and personal care. In 2002, with the implementation of the Care Standards Act, Shared Lives Carers that provided accommodation and personal care were individually registered as 'care homes providing adult placement'. This approach proved to be highly unsatisfactory with two thirds of the sector remaining unregulated and the regulatory requirements of those that came within regulation proving inappropriate for Shared Lives arrangements. With the support of the regulator the Department of Health changed the regulatory approach in 2004, lifting the burden of regulation from individual Shared Lives families and regulating instead the Shared Lives Scheme. This approach has proved more effective in raising standards in Shared Lives, bringing all Shared Lives arrangements under regulation. Supported Lodging schemes differ in the amount of support given and are regulated only by the legislation covering housing in multiple occupancy. This is a much looser regulatory framework. Who are they for? Shared Lives schemes and Supported Lodgings schemes have been developed for a range of different groups of people. Details of whether schemes for people with learning disabilities exist in a particular area can be obtained from the local authority Social Services department. It might be anticipated that Shared Lives arrangements would be more likely to suit particular groups of people more than others but this has proved not to be so. It has been found to be successful for a wide range of people coming from differing circumstances with both high and low levels of need or disability. Arrangements are likely to be most successful where they meet the wishes and needs of the individual either because they have expressed a preference for this type of accommodation or because people who have got to know the individual assess the person concerned would be particularly suited to the type of support available. In general Supported Lodgings are likely to be more appealing to a group of people who are independent but vulnerable and therefore need someone to be available to monitor, prompt and advise on problems. There are few, if any, criteria people applying to either type of scheme have to meet other than an assessed need and a desire to access the service. Shared Lives Short Breaks Services are available to a widely divergent group of people. They have proved particularly successful for people with learning disabilities.

4 Support Most Shared Lives schemes have been set up for the benefit of people who are assessed as needing community care services. Usually Social Services Departments will be funding the organisation running the Shared Lives Scheme, if not managing schemes themselves. Currently access is therefore usually through the Care Assessment and Management process although Shared Lives arrangements are increasingly purchased through direct payments (short breaks and day services) or personal budgets. Where the service is accessed through care management: Once matching is complete the Care Manager continues to support the person in their placement and monitor the service being provided. The Shared Lives Worker also monitors the arrangement and provides support to the host family. Although the role of the Shared Lives Worker is primarily to recruit, prepare, co-ordinate and support the host family, from time to time they will also be a source of support to the guest. In reality they are often the first to respond to the guest as they are likely to be in most regular contact with the guest, meeting them when visiting the placement. This is particularly true whilst the placement is settling down and during times of difficulty or instability. The guest receives most of their day to day support directly from the host family. The level of support will depend on the needs of the individual. This would normally be agreed between all parties prior to the placement beginning or during a trial period. As a minimum support usually includes prompting with daily routines, providing and preparation of meals, help with budgeting and could, by negotiation include help with laundry, transport and daily living. In some circumstances it could include help with personal and intimate care including washing and toileting. People living in Shared Lives arrangements are also be entitled to use existing community care services like home helps, nurses and physiotherapists depending on the level of support they need. Shared Lives arrangements for some very severely disabled people have proved very successful although as with any family the presence of additional supports are an essential part of a comprehensive care package including use of respite and short breaks services. This support is made available as part of a Community Care Plan if found to be necessary. Scheme organisers have found that mutual support groups of host families or guests can be beneficial. Also others such as the family of the guest who although unable to provide the day to day care may play a crucial supporting role for both the guest and host family by providing respite or well informed advice. NAAPS UK was formed in 1992 to promote and develop Shared Lives and other types of small community services. It acts as an umbrella organisation for Shared Lives schemes throughout the country representing the interests of all those involved in this unique form of care. It works to improve and maintain standards, promote awareness and acts as a resource centre to individuals using schemes, carers and workers. If you would like to know what support is available in your area through Shared Lives NAAPS holds a database of schemes currently operating in the UK.

5 Funding The arrangements for funding Shared Lives arrangements are the same across the UK although costs vary from local authority to local authority. The majority of placements cost more than the money that is collected from the guest. The additional cost is met by the Local Authority. The costs that have to be met include the employment of Shared Lives Workers, the payment to the host family and other services needed to support the arrangement. The local authority normally covers the cost of employing the Shared Lives workers and does not pass this on to the guest. The guest covers the cost of accommodation and Board from their own resources and the local authority will pay the cost of the support provided by the Shared Lives family. The level of the support payment will depend upon the support needs of the guest, who will be assessed under the Fairer Charging rules for their financial contribution to the support cost. Below is an example of a typical Shared Lives financial arrangement: Total cost of arrangement paid weekly to host family Made up from: Accommodation charge (usually paid through housing benefit) Board and utility bills (usually met through benefits) Support (gross payment from the local authority)* Note: The guest will be charged under the Fairer Charging rules for their contribution to the cost of support. People living with Shared Lives families are able to claim the same range of benefits accessed by anyone else living in the community e.g.: In Supported Lodgings In Supported Lodgings the individual is only deemed to need accommodation and food but not care and pay for this from their own resources (usually benefits). Housing related support can be funded by the local authority, usually from the Supporting People grant. Tenants are not required to pay a contribution to the cost of housing related support funded through Supporting People (although may be if the funding is from Community Care monies. People living in Supported Lodgings can have a higher level of disposable income than people living in Shared Lives arrangements as they are not required to pay a contribution towards the cost of their care. This is often offset however by the fact that people receive a higher level of benefit (e.g. middle or high rate DLA (care), Severe Disability Premium) Retainers are sometimes paid by Local Authorities to both Shared Lives Families and Supported Lodging Landlords to ensure accommodation is kept available for emergency placement or to keep open placements for people in hospital. Short Breaks Services provided through Shared Lives are normally funded in a similar way to residential short breaks services, although increasingly people are purchasing these services using direct payments.

6 Security One of the features of Shared Lives Schemes is the flexibility to meet different needs. It has however been a criticism of Shared Lives that it does not offer the same occupancy rights that go with owning or renting your own home. People living in Shared Lives arrangements are provided with a licence agreement but this does not offer the same security as an assured tenancy. The guest can be asked to leave at four weeks notice and has no legal means of challenging such action. Shared Lives families do not enter into such arrangements lightly. They do so only if they feel able to provide accommodation and support for the length of time required by the individual. Many Shared Lives arrangements are stepping stones to more independent living and are time limited others are more open ended. Situations can arise that result in Shared Lives families moving house or taking a job out of the area. Sometimes the individual chooses to move with the family - but other people may choose to stay in the area and find another accommodation option. Moving area can bring problems as the new local authority area may not accept the same level of financial responsibility or provide the same resources. Shared Lives Schemes will work with the individual to find the best way forward for them. In a Supported Lodging arrangement where the guest/lodger is living in the same house as the landlord and paying a weekly rent the security of tenure is similar. It is usual for the lodger to have some form of licence agreement. In the case of short-term breaks the guest has no security. The placements are intended only as short term breaks and not as a permanent home. Maintenance and Repair Once the charge for the Shared Lives arrangement is met there are no additional costs to the guest. The host family is responsible for meeting all the housing occupancy, maintenance and repair costs, including heating and lighting. The only exception might be where a guest's deteriorating health leads to adaptations being required to make the property accessible to allow the guest to continue living in the accommodation. In this situation the host family would need to agree to any work being carried out. In such circumstances if the host family agree it may be possible for the local authority to make a grant to meet the cost of adapting the building to meet the needs of the guest. If the guest is responsible for deliberate damage to the property they may be required to meet the cost of repair although this will depend on the type of household insurance the host family possess. NAAPS UK has organised a special insurance policy to cover liabilities, protecting the host family, their property and guest. Part of the preparation that takes place between the Scheme worker and the host family is to ensure issues such as this are addressed before the placement begins. Guests moving in to live with a Shared Lives family are normally encouraged to bring their own possessions and furnishings although the limitations of space may mean the guest is not able to bring a large number of personal possessions.

7 In the case of Supported Lodgings the tenant will need to determine what the rent includes and whether the accommodation is fully furnished. It would usually be the case that an element of the rent would cover maintenance and repairs. This would be stated in the agreement. Risks There are a number of risks inherent in Shared Lives or Supported Lodgings arrangement which will need to be considered before deciding to choose one of these as a preferred option for longer term accommodation: Shared Lives Lack of security of tenure. Host family unable to meet changing needs. Relationship difficulties which lead to a breakdown of the arrangement. Supported Lodging Lack of security of tenure Little or no regulation of lodgings. Low level of support. Heavily dependent on qualities and skills of landlord/landlady.

8 Pros and Cons Shared Lives - Pros Greater flexibility to meet the individual requirements of the person Opportunity to experience or continue to enjoy family life Higher chance of being included in the community. Able to make personal attachments that will last. Person gets more involved in family life than in Supported Lodgings. Good support from those organising placements. Cons Lack of security of tenure. Circumstances may change for host family leading to placement ending Sharing family life can be oppressive for people that need a high degree of privacy Little scope to retain large personal possessions. People can outgrow each other and need to move on Host family may not be able to meet changing needs and person may need to move. The tenant gets the extra support that can make the difference between living independently and residential care. Level of support may be greater than needed and create dependency Access to housing benefits and other benefits ensures good level of disposable income.

9 Supported Lodgings Supported Lodgings - Pros The tenant gets the extra support that can make the difference between living independently and residential care. Unfurnished lodgings allow people to retain large possessions Access to housing benefits and other benefits ensures good level of disposable income No requirement to share family life suits people who need a high level of privacy. Cons Support can feel intrusive once the tenant gets established Low level of support from scheme Little or no regulation. Short Breaks - Pros People find it a more enjoyable experience than stays in large residential homes. Person to person support. Opportunity to develop mutual interests. Greater flexibility means breaks are available when people need them. No need to book a year in advance. It is a 'normal' experience to stay with another family. Can be very popular with families who see it as a more natural break. Shared Lives families can provide support and form friendships with birth families Increased choice. Cons Host families may leave leading to inconsistencies in services. Families may worry that financial motives are foremost in mind of host family. Families feel residential care is safer. Poor matches or preparation may mean that host families are ill prepared to cope with quite specialist needs. Some people find family life oppressive and may prefer a residential setting

10 Comments and Issues For some people Shared Lives provides the ideal solution. The matching process means however that Shared Lives is rarely an emergency option and the number of people benefiting from long term permanent placement is always likely to be lower than those using residential care or care at home. Evidence from existing Schemes shows that Shared Lives arrangements can be very successful even for very severely disabled people. There can be much greater scope for promoting choice with Shared Lives than traditional services. Further information is available from: National Development Team NDT Hill View Business Park Old Ipswich Road, Claydon Ipswich IP6 0AJ Tel: Fax: Website: NAAPS UK Suite 6 The Cotton Exchange Old Hall Street Liverpool L3 9LQ Tel: Fax: Website: Care Quality Commission